1. Progress Report Presentation:
Learning Retention and the Timing of Refresher Education
After The Deliberate Practice of Radiograph Interpretation
K. Boutis, M. Pecaric, J. Beckstead, P. Babyn, M. Pusic
UToronto, USF, NYU
IMSH 2014: San Francisco, CA / USA
International Network for Simulation-based Pediatric Innovation, Research and Education
2. Background
• Content Area: PEM Radiology
• Instructional Design:
Online Deliberate Practice (Screen Simulation)
• Question:
What is the rate of skill decay?
International Network for Simulation-based Pediatric Innovation, Research and Education
3. PICO Question
P: PEM Fellows
I:
Online deliberate practice
C: Same + Refresher Training
O: Knowledge retention over 18 mo
International Network for Simulation-based Pediatric Innovation, Research and Education
4. Marty, can you create a
Couple of screenshot slides
From the tutorial (showing lines)
And from one case showing
Feedback with green.
5. Marty, can you create a
Couple of screenshot slides
From the tutorial (showing lines)
And from one case showing
Feedback with green.
8. Study Protocol
Two Phases:
1. Radiograph Calibration
– Remove educationally poor cases
– Broad sample of expertise
– Use Rasch Modelling to ensure appropriate difficulty
2. Actual Trial
– Target Population
International Network for Simulation-based Pediatric Innovation, Research and Education
9. PICO Question
Final Sample size: 100 + 100
CALIBRATION:
TRIAL:
(Read 100 Xrays (Read 220
Once)
Xrays/18mo)
Medical Students
20
EM Residents
20
Peds Residents
20
PEM Fellows
20
PEM Attendings
10
Peds Radiology
10
40
60
International Network for Simulation-based Pediatric Innovation, Research and Education
10. Approach / Design
Adding fourth group: No Refresher
International Network for Simulation-based Pediatric Innovation, Research and Education
11. Overlearning
Slope of Decay Curve
Area Under Curve
COMPETENCE
Refresher Training
PERFORMANCE
Approach / Design
Training -- Learning (Units of
Deliberate Practice)
Skill Degradation
Stops
training
(Units of Elapsed Time)
TIME
12. PICO Question
Final Sample size: 100 + 100
CALIBRATION:
TRIAL:
(Read 100 Xrays (Read 220
Once)
Xrays/18mo)
Medical Students
20
EM Residents
20
Peds Residents
20
PEM Fellows
20
PEM Attendings
10
Peds Radiology
10
40
60
International Network for Simulation-based Pediatric Innovation, Research and Education
13. Progress since Jan 2013
• Calibration phase almost completed
• IRB through at:
– University of Toronto
– NYU
– Dalhousie
– Universite de Montreal
International Network for Simulation-based Pediatric Innovation, Research and Education
14. Needs / Challenges
1. Going well
2. IRB issues for coinvestigators
3. Keeping people in the study over the
18 months.
International Network for Simulation-based Pediatric Innovation, Research and Education
15. How can INSPIRE help?
1. @ IMSH 2014: Recruit 2 centers
2. In 3 months: Commence study phase 2
3. Over 1 year: Continue data collection
International Network for Simulation-based Pediatric Innovation, Research and Education
